View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 0930-0320	ICR Reference No: 201705-0930-002
Status: Historical Active	Previous ICR Reference No: 201403-0930-005
Agency/Subagency: HHS/SAMHSA	Agency Tracking No: 21577
Title: CABHI Evaluation Client & Stakeholder Surveys
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/27/2017
	Date Received in OIRA: 05/12/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2020	36 Months From Approved	06/30/2017
Responses	11,269	0	11,241
Time Burden (Hours)	5,098	0	4,006
Cost Burden (Dollars)	0	0	0

Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
6-Month Followup	6-Month Followup
Baseline	Baseline
Stakeholder Survey	Stakeholder Survey_Wave3, Stakeholder Survey_Wave1, Stakeholder Survey_Wave2	, ,

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate
Annual Number of Responses	11,269	11,241	132	-104
Annual Time Burden (Hours)	5,098	4,006	139	953
Annual Cost Burden (Dollars)	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Currently there are 4,006 total burden hours in the OMB inventory. SAMHSA is requesting 5,098; an increase of 1,092 hours. This is due to the response burden times have been revised to reflect real-world experience during the Homeless Programs evaluation. Additionally, for the Stakeholder Survey, up to 78 grantees are expected to participate each year in the evaluation.

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